Publication, Part of National Diabetes Footcare Audit

NDFA Interval Review: July 2014-March 2021

Audit

Publication Date:: 11 May 2022
Geographic Coverage:: England, Wales
Geographical Granularity:: NHS Trusts, Community health services, Independent Sector Health Care Providers, Strategic Health Authorities, Hospital and Community Health Services, Clinical Commissioning Groups
Date Range:: 14 Jul 2014 to 31 Mar 2021

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1. Executive summary

Updates to mapping of foot care services

This report was updated on 21 June 2022. The following updates to the specialist foot care service mappings used in the analysis have been applied:

•   Service RW501a has been mapped to RW5, rather than RW4
•   Service RW501d has been mapped to RW4, rather than RW5 (as intended)
•   Service 7A3C7c has been mapped to 7A3, rather than 7A5
•   Service 7A3C7d has been mapped to 7A3, rather than 7A5
•   Service 7A3C7a/7A5B1a is still mapped to 7A5, rather than 7A3 (as intended)
•   The name used for service R0B0Qa has been standardised to: "South Tyneside Inpatient Podiatry Team". R0B0Qa was previously listed with two names: "South Tyneside District Hospital" and "South Tyneside Inpatient Podiatry Team".

The updated mappings have affected:

NDFA Interval Review: July 2014-March 2021:
https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-footcare-audit/2014-2021
• Text on tab "3. Findings": 3.4. Regional variation: Alive and ulcer-free at 12 weeks
https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-footcare-audit/2014-2021/findings
• Text and Appendix 5.8 on tab "5. Appendices": https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-footcare-audit/2014-2021/appendices

NDFA Interval Review 2014-21 - Main Report v1.1 (pptx and pdf):
• Text on Slide 11
• Text and Appendix 5.8 on Slide 24

NDFA Interval Review 2014-21 - Open Data v1.1.csv:
• Updated figures where Output_Reference = "Appendix 5.8"

NDFA Interval Review 2014-21 - Audit Participation v1.1.xlsx
• Text on tab: "Title sheet"
• Mappings on tab: "Data"

21 June 2022 09:00 AM

Update to Appendix 5.6

This report was updated on 12 August 2022.

Appendices 5.6a and 5.6b have been updated after an error was identified in the analysis code. The corrected figures for 5.6a still show a steep increase in heart failure, but rates of myocardial infarction and stroke are now flat, rather than upward. Updated figures for 5.6b are similar to those previously published.

The updated analysis has affected:

NDFA Interval Review: July 2014-March 2021:
https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-footcare-audit/2014-2021
• Text and Appendix 5.6 on tab "5. Appendices": https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-footcare-audit/2014-2021/appendices

NDFA Interval Review 2014-21 - Main Report v1.1 (pptx and pdf):
• Text on Slide 1
• Text and Appendix 5.6 on Slide 22

NDFA Interval Review 2014-21 - Open Data v1.1.csv:
• Updated figures where Output_Reference = "Appendix 5.6"

12 August 2022 14:53 PM

Summary

The National Diabetes Foot Care Audit (NDFA) Interval Review is the 6th NDFA report. The NDFA is a continuous audit of diabetic foot disease in England and Wales. The audit enables all diabetes foot care services to measure their performance against the National Institute for Health and Care Excellence (NICE) clinical guidelines and peer units, and to monitor adverse outcomes for people with diabetes who develop diabetic foot disease. All organisations which provide a diabetic foot ulcer treatment service are eligible for inclusion in the audit. The audit reports on the following:

Structures: are the nationally recommended care structures in place for the management of diabetic foot disease?
Processes: does the treatment of active diabetic foot disease comply with nationally recommended guidance?
Outcomes: are the outcomes of diabetic foot disease optimised?

The NDFA is part of the National Diabetes Audit (NDA) portfolio within the National Clinical Audit and Patient Outcomes Programme (NCAPOP), commissioned by the Healthcare Quality Improvement Partnership (HQIP).

Key Facts

The NDFA Interval Review has found:

An increase in the proportion of referrals seen by a specialist foot care team within 13 days

From 43% in 2014-15 to 46% in 2020-21

A linked reduction in the proportion of ulcers that are graded as severe at first expert assessment (FEA)

From 48% in 2014-15 to 43% in 2020-21

A linked reduction in the proportion of ulcers still active (not healed) at 12 weeks after FEA

From 49% in 2014-15 to 40% in 2020-21

To help guide service improvement, the NDFA has identified recommendations that aim to further improve foot care provision and outcomes. Full details of the NDFA findings and recommendations are published in subsequent chapters of the report.